Mercè Boada, Oscar L. López, Javier Olazarán, Laura Núñez, Michael Pfeffer, Orlando Puente, Gerard Piñol-Ripoll, José E. Gámez, Fernando Anaya, Dobri Kiprov, Montserrat Alegret, Carlota Grifols, Miquel Barceló, Jordi Bozzo, Zbigniew M. Szczepiorkowski, Antonio Páez, the AMBAR Trial Group
We report the effects of plasma exchange (PE) with albumin replacement on neuropsychological, neuropsychiatric, and quality-of-life (QoL) outcomes in mild-to-moderate Alzheimer’s disease (AD) patients in a phase 2b/3 trial (Alzheimer’s Management by Albumin Replacement [AMBAR] study).
Three hundred forty-seven patients were randomized into placebo (sham-PE) and three PE-treatment arms with low/high doses of albumin, with/without intravenous immunoglobulin (IVIG). Specific test measurements were performed at baseline; month 2 (weekly conventional PE); months 6, 9, and 12 (monthly low-volume PE [LVPE]); and month 14.
The PE-treated mild-AD cohort improved their language fluency and processing speed versus placebo at month 14 (effect sizes: >100%; P-values: .03 to .001). The moderate-AD cohort significantly improved short-term verbal memory (effect sizes: 94% to >100%; P-values: .02 to .003). The progression of the neuropsychiatric symptoms of PE-treated was similar to placebo. Mild-AD patients showed improved QoL (P-values: .04 to .008).
PE-treated AD patients showed improvement in memory, language abilities, processing speed, and QoL-AD. No worsening of their psychoaffective status was observed.